| |
5475 Chamblee Dunwoody Rd, Dunwoody, GA 30338-4114 | |
(678) 379-1300 | |
(678) 802-3209 |
Full Name | |
---|---|
Type | Facility |
Speciality | Family Medicine |
Location | 5475 Chamblee Dunwoody Rd, Dunwoody, Georgia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1316392541 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | LD004684 (Georgia) | Secondary |
207Q00000X | Family Medicine | 56363 (Georgia) | Primary |
207Q00000X | Family Medicine | RN108447 (Georgia) | Secondary |
Mailing Address | Practice Location Address |
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5024 Vernon Springs Dr, Dunwoody, GA 30338-4653 Ph: (404) 229-9048 | 5475 Chamblee Dunwoody Rd, Dunwoody, GA 30338-4114 Ph: (678) 379-1300 |